Publications by authors named "Bulent Cetin"

62 Publications

Understanding relevant immune mechanisms in gastrointestinal oncology.

J Oncol Pharm Pract 2021 Feb 8:1078155221992862. Epub 2021 Feb 8.

Department of Medicine, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.

Rapid and successful drug development has resulted in multiple treatment options for gastrointestinal cancer, requiring careful decision making for individual patients. The general theme in modern immunology is that the field is moving beyond establishing the fundamental principles of immune response mechanisms to applying these propositions to understand human diseases and develop new therapies. Immunotherapy has contributed enormously to cancer treatments with a virtual explosion in novel therapeutics including checkpoint inhibitors and other recently developed immunomodulators and the development of novel therapeutic approaches. Although the majority of gastrointestinal (GI) cancers are generally considered poorly immunogenic, clinical trials have revealed that some of the patients with various gastrointestinal cancers are highly responsive to immune checkpoint inhibition-based therapies. We paid special attention to the clinical relevance of immunology and emphasized how newly developed therapies work, including what their strengths and pitfalls are. This review aims to enhance the interest of practitioners in the many specialties and subspecialties that the discipline influences and to assist them in understanding this increasing complexity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1078155221992862DOI Listing
February 2021

Is there any relationship between Helicobacter pylori infection and human epidermal growth factor receptor 2 expression in gastric cancer?

J Cancer Res Ther 2020 Dec;16(Supplement):S128-S132

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

Purpose: Helicobacter pylori(HP) is a significant causative agent of gastric cancer (GC). However, the underlying mechanisms involved in its pathogenesis and association with oncoproteins are unclear. The aim of the present study was to evaluate the relationship between HP infection and human epidermal growth factor receptor 2 (HER2) expression in GC patients.

Materials And Methods: Surgery (173) or endoscopic biopsy (35) specimen of 208 patients diagnosed with GC was evaluated for the presence of HER2 and HP. HER2 expression was assessed by fluorescence in situ hybridization (FISH) method, whereas HP status was evaluated histologically. Giemsa stain was used to identify HP status, in case HP could not be recognized in routine H and E-stained sections despite careful examination.

Results: The median age was 63 years (27-91), and most patients were male (male/female: 149/59). Of all the 208 patients, HP was positive in 87 (41.8%) and negative in 121 (58.2%) patients. FISH positivity for HER2 was observed in 41 (19.7%) patients, whereas FISH negativity was observed in 167 (80.3%) patients. According to the Chi-square test, patient distribution was 21 in HER2-positive HP-negative group, 20 in HER2-positive HP-positive group, 100 in HER2-negative HP-negative group, and 67 in HER2-negative HP-positive group. No correlation was found between HP and HER2 status (P = 0.314). HP positivity had significant effect on median overall survival (27.4 vs. 12.9 months, P = 0.046).

Conclusions: Our results suggest that there is no relationship between HP infection and HER2 status in patients with GC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jcrt.JCRT_891_18DOI Listing
December 2020

The DNA damaging revolution.

Crit Rev Oncol Hematol 2020 Dec 3;156:103117. Epub 2020 Oct 3.

UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California, United States.

Poly(ADP-ribose) polymerase (PARP) is a nuclear enzyme that plays a critical role in the repair of single-strand DNA damage via the base excision repair pathway. PARP inhibitors have substantial single-agent antitumor activity by inducing synthetic lethality. They have also emerged as promising anticancer targeted therapies, especially in tumors harboring deleterious germline or somatic breast cancer susceptibility gene (BRCA) mutations. PARP inhibition produces single-strand DNA breaks, which may be repaired by homologous recombination, a process partially dependent on BRCA1 and BRCA2. The PARP inhibitors olaparib, veliparib, talazoparib, niraparib, and rucaparib have predominantly been studied in patients with breast or ovarian cancers associated with deleterious germline mutations in BRCA1 and BRCA2. Ongoing clinical trials are evaluating the role of PARP inhibitors alone and in combination with other therapies, including selective inhibitors against key targets involved in the DNA damage response. In this review we summarize the use of PARP inhibitors in various tumor types, as well as possible approaches for overcoming resistance to PARP inhibitors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.critrevonc.2020.103117DOI Listing
December 2020

Pembrolizumab for Early Triple-Negative Breast Cancer.

N Engl J Med 2020 06;382(26):e108

UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1056/NEJMc2006684DOI Listing
June 2020

Can you draw the picture of happiness- Treatment of a young woman with breast cancer during the COVID-19 pandemic.

Asian J Psychiatr 2020 08 19;52:102174. Epub 2020 May 19.

UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California, USA.; Department of Internal Medicine, Division of Medical Oncology, Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajp.2020.102174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236698PMC
August 2020

The Potential for Chemotherapy-Free Strategies in Advanced Prostate Cancer.

Curr Urol 2019 Oct 1;13(2):57-63. Epub 2019 Oct 1.

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

The treatment landscape for advanced prostate cancer is evolving rapidly, with new agents and strategies, and more optimal use of existing therapies under constant development. Efforts were focused on better understanding of the biology of the disease. This effort has paved the way for a more contemporary and effective therapies to be developed. There are now 6 FDA-approved therapies that increase overall survival. These include the immunotherapy sipuleucel-T; the 2 androgen pathway inhibitors: abiraterone acetate and enzalutamide; 2 chemotherapy drugs: docetaxel and cabazitaxel; and the radionuclide: radium-223. Advanced prostate cancer may be one of the few cancers for which multiple chemotherapy and nonchemotherapy regimens are considered as standard. Several recently published clinical trials have demonstrated the suprising activity of chemotherapy-free strategies, and we should not be too eager to discount these "old-fashioned" treatments. Optimal sequencing is still unclear because new therapies have proliferated so quickly that comparative data are limited. In this short communication, we identify current challenges and unmet needs in advanced prostate cancer and provide an overview of their respective clinical activity, while highlighting distinctions between therapies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000499292DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6873020PMC
October 2019

Game of thrones: immunotherapy versus molecular targeted therapy in renal cell cancer scenarios.

Int Urol Nephrol 2019 Dec 29;51(12):2107-2117. Epub 2019 Aug 29.

Department of Urology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey.

Objectives: Treatment for advanced renal cell carcinoma (RCC) has become increasingly more complex over the last several years. Objective 1 is to which treatment option is immunotherapy, targeted therapy, or the combination of immunotherapy with targeted therapy the best for patients? Objective 2 is to study which regimens with the highest chance of cure/durable response and what is the optimal sequence in advanced RCC.

Materials And Methods: Between 2016 and 2018, 6 adult patients admitted to our institute with RCC were reviewed. Clinical information, treatment and outcomes were retrieved for further analysis. This applies to all risk groups as determined by the International Metastatic RCC Database Consortium criteria. We have intended to provide the reader with a comprehensive and authoritative review of the broad subject of RCC.

Results: Immunotherapy-based regimens and the functioning of various growth-and survival-promoting kinases, specifically, receptor-associated tyrosine kinases have dramatically changed the treatment landscape of advanced RCC. Recent phase III trials have demonstrated a survival benefit for front-line ipilimumab plus nivolumab therapy, and immune checkpoint inhibition plus anti-vascular endothelial growth factor combination therapy in metastatic clear-cell RCC.

Conclusion: In renal cell carcinoma, rapid and successful drug development has resulted in multiple treatment options, requiring careful decision making for individual patients and have emphasized how newly developed therapies work.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11255-019-02264-5DOI Listing
December 2019

Managing Synchronous Liver Metastases in Colorectal Cancer.

Indian J Surg Oncol 2018 Dec 18;9(4):461-471. Epub 2018 May 18.

2Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

The most common site of blood-borne metastases from colorectal cancers (CRC) is the liver. Resection of (liver) metastases is a part of standard treatment of metastatic colorectal cancer. Hepatic resection is the first-line treatment of liver metastases, with 5-year survival rates between 25 and 58%. The enhanced efficacy of systemic chemotherapeutic regimens has increased tumor response rates and improved the progression-free and overall survival of patients with these malignancies. In approximately 20% of patients with initially unresectable liver metastases, the metastases may become resectable after administration of neoadjuvant chemotherapy. Unresectable liver metastases can be managed with systemic therapy and/or a variety of liver-directed techniques such as radiofrequency ablation, hepatic artery infusion, or yttrium-90 radioembolization. Our examination of the literature led us to propose a new patient-oriented algorithm to guide clinicians' decisions on the best choice of upfront therapy for CRC and synchronous liver metastases. The need for multidisciplinary consensus has become especially important for metastatic CRC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13193-018-0765-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6265172PMC
December 2018

Current uses of check inhibitors in the fight against advanced and/or metastatic lung cancer: will immunotherapy overcome chemotherapy?

Curr Probl Cancer 2019 02 4;43(1):43-53. Epub 2018 Aug 4.

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

Lung cancer is the most common cause of cancer death worldwide. Treatment for lung cancer has become increasingly more complex over the last several years. Immune checkpoint inhibitors have dramatically changed the treatment landscape of advanced nonsmall cell lung cancer (NSCLC). There are currently 3 approved checkpoint inhibitors for patients with NSCLC who progressed after platinum-doublet chemotherapy (Pembrolizumab and /or Nivolumab and /or Atezolizumab). Avelumab and durvalumab are currently under investigation in phase 3 trials. Pembrolizumab has now been approved for first-line use in NSCLC, after a trial showed improved survival compared with chemotherapy in patients who were positive for programmed cell death ligand 1. Giving our patients the best, personalized approach to their individual cancer can improve their quality of life and survival and help us use our limited resources most efficiently. In the present review, we provide a new patient-oriented algorithm to guide clinicians' decisions on the best choice of therapy for advanced NSCLC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.currproblcancer.2018.07.008DOI Listing
February 2019

Carbonic anhydrase IX is a prognostic biomarker in glioblastoma multiforme.

Neuropathology 2018 Oct 28;38(5):457-462. Epub 2018 Jun 28.

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

The identification of prognostic factors in patients with glioblastoma multiforme (GBM) represents an area of increasing interest. Carbonic anhydrase IX (CA-IX), a hypoxia marker, correlates with tumor progression in a variety of human cancers. However, the role of CA-IX in GBM remains largely unknown. In the present study, we evaluated the prognostic role of CA-IX in GBM patients. In total, 66 consecutive patients with GBM who received concomitant chemoradiotherapy and adjuvant chemotherapy with temozolomide were retrospectively reviewed, and all patients received temozolomide chemotherapy for at least 3 months. Kaplan-Meier curves and log-rank tests were used for analysis of progression-free survival (PFS) and overall survival (OS), and a multivariate Cox proportional hazard model was employed to identify factors with an independent effect on survival. The median OS was longer in patients with low levels of CA-IX expression (18 months) compared to patients overexpressing CA-IX (9 months) (P = 0.004). There was not a statistically significant difference in median PFS (3.5 vs. 8 months, P = 0.054) between patients with high or low levels of CA-IX expression. In multivariate analysis, the variables that were identified as significant prognostic factors for OS were preoperative Karnofsky performance scale score (KPS) (hazard ratio (HR), 3.703; P = 0.001), CA-IX overexpression (HR, 1.967; P = 0.019), and incomplete adjuvant temozolomide treatment (HR, 2.241; P = 0.003) and gross-total resection (HR, 1.956; P = 0.034). Our findings indicated that CA-IX may be a potential prognostic biomarker in the treatment of GBM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/neup.12485DOI Listing
October 2018

Assessment of Multi Fragment Melting Analysis System (MFMAS) for the Identification of Food-Borne Yeasts.

Curr Microbiol 2018 Jun 26;75(6):716-725. Epub 2018 Feb 26.

Department of Gastronomy and Culinary Arts, Gelisim University, Istanbul, Turkey.

Multi Fragment Melting Analysis System (MFMAS) is a novel approach that was developed for the species-level identification of microorganisms. It is a software-assisted system that performs concurrent melting analysis of 8 different DNA fragments to obtain a fingerprint of each strain analyzed. The identification is performed according to the comparison of these fingerprints with the fingerprints of known yeast species recorded in a database to obtain the best possible match. In this study, applicability of the yeast version of the MFMAS (MFMAS-yeast) was evaluated for the identification of food-associated yeast species. For this purpose, in this study, a total of 145 yeast strains originated from foods and beverages and 19 standard yeast strains were tested. The DNAs isolated from these yeast strains were analyzed by the MFMAS, and their species were successfully identified with a similarity rate of 95% or higher. It was shown that the strains belonged to 43 different yeast species that are widely found in the foods. A clear discrimination was also observed in the phylogenetically related species. In conclusion, it might be suggested that the MFMAS-yeast seems to be a highly promising approach for a rapid, accurate, and one-step identification of the yeasts isolated from food products and/or their processing environments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00284-018-1437-9DOI Listing
June 2018

Pazopanib-Induced Hepatotoxicity in an Experimental Rat Model.

Chemotherapy 2018 24;63(1):39-45. Epub 2018 Jan 24.

Department of Internal Medicine, Division of Medical Oncology, Recep Tayyip Erdogan University Faculty of Medicine, Rize, Turkey.

Pazopanib is an effective treatment for advanced renal cell carcinoma and soft tissue sarcoma. Besides classical adverse events of this drug class, hepatotoxicity has been described as a frequent side effect. The aim of the present study was to evaluate the effect of pazopanib on the liver in an experimental rat model. Sixteen Wistar albino rats were divided into 3 groups: experimental toxicity was induced with pazopanib (10 mg/kg) administered for 28 days (group 2) or 56 days (group 3) orally by gavage. Group 1 (control group) received only distilled water. Rats in groups 2 and 3 were sacrificed after the collection of blood and tissue samples on the 28th and 56th days, respectively. We found significant differences in bilirubin, alkaline phosphatase, lactate dehydrogenase, glucose, triglyceride, very-low-density lipoprotein, and iron values (p < 0.050 for all) but none in any other parameter (p > 0.050). All rats in the control group had normal histological features; however, none of the rats in groups 2 and 3 showed normal histology. In group 2, we observed mild sinusoidal dilatation, congestion, enlarged Kupffer cells, accumulation of yellow-brown-black pigment in the Kupffer cells and the accumulation of hemosiderin with Prussian blue reaction in the hepatocytes. In group 3, the findings mentioned above were more prominent, and besides these findings focal acinar transformation and macrovesicular steatosis were also observed. In group 3, mild inflammation within the portal areas was observed consisting of lymphocytes, neutrophils, and eosinophils. This study is the first that reports the biochemical and histopathological evaluation of pazopanib-related hepatic toxicity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000481795DOI Listing
March 2018

Intravascular Large B-Cell Lymphoma of the Gallbladder.

Turk J Haematol 2018 May 2;35(2):145-146. Epub 2018 Feb 2.

Gazi University Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Ankara, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tjh.2017.0276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972344PMC
May 2018

Erratum to: Application of high-resolution melting analysis for differentiation of spoilage yeasts.

J Microbiol 2017 12;55(12):989

Erciyes University, Faculty of Engineering, Food Engineering Department, Kayseri, 38039, Turkey.

In the article by Erdem et al. published in Journal of Microbiology 2016; 54, 618-625, the figure 1 should be corrected as below.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12275-017-0671-3DOI Listing
December 2017

Retinal Metastases From Anaplastic Astrocytoma.

Am J Med Sci 2017 Aug 24;354(2):217. Epub 2017 Feb 24.

Department of Medical Oncology, Recep Tayyip Erdogan University Faculty of Medicine, Rize, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amjms.2017.02.003DOI Listing
August 2017

as target in gastric adenocarcinoma.

Transl Gastroenterol Hepatol 2016 22;1:59. Epub 2016 Jul 22.

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/tgh.2016.06.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5244761PMC
July 2016

Application of high-resolution melting analysis for differentiation of spoilage yeasts.

J Microbiol 2016 Sep 31;54(9):618-625. Epub 2016 Aug 31.

Faculty of Engineering, Food Engineering Department, Erciyes University, Kayseri, 38039, Turkey.

A new method based on high resolution melting (HRM) analysis was developed for the differentiation and classification of the yeast species that cause food spoilage. A total 134 strains belonging to 21 different yeast species were examined to evaluate the discriminative power of HRM analysis. Two different highly variable DNA regions on the 26 rRNA gene were targeted to produce the HRM profiles of each strain. HRM-based grouping was compared and confirmed by (GTG)5 rep-PCR fingerprinting analysis. All of the yeast species belonging to the genera Pichia, Candida, Kazachstania, Kluyveromyces, Debaryomyces, Dekkera, Saccharomyces, Torulaspora, Ustilago, and Yarrowia, which were produced as species-specific HRM profiles, allowed discrimination at species and/or strain level. The HRM analysis of both target regions provided successful discrimination that correlated with rep-PCR fingerprinting analysis. Consequently, the HRM analysis has the potential for use in the rapid and accurate classification and typing of yeast species isolated from different foods to determine their sources and routes as well as to prevent contamination.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12275-016-6017-8DOI Listing
September 2016

Crizotinib-induced toxicity in an experimental rat model.

Wien Klin Wochenschr 2016 Jun 14;128(11-12):435-41. Epub 2016 Mar 14.

Department of Internal Medicine, Division of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.

Aim: The aim of the present study was to evaluate the effect of crizotinib on visceral organs in an experimental rat model.

Methods: Eighteen Wistar albino rats were divided into three groups: experimental toxicity was induced with crizotinib (10 mg/kg) administered for 28 days (Group 1), 42 days (Group 2) orally by gavage. Control group received only distilled water. Rats in Group 1 and Group 2 were sacrificed after the collection of blood and tissue samples on the 28th and 42nd days, respectively.

Results: Subjects in Group 1 and Group 2 had abnormal histology mainly in lung and liver. There were intraalveolar hemorrhage in lungs; mild portal inflammation, perivenular focal and confluent necrosis in liver; inflammatory reaction in renal pelvis and periureteral areas, and focal pancreatitis in pancreas.

Conclusion: This study is the first to evaluate the histopathological features of toxicity of crizotinib in a rat model.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00508-016-0984-yDOI Listing
June 2016

Advances of Molecular Targeted Therapy in Gastric Cancer.

J Gastrointest Cancer 2016 Jun;47(2):125-34

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

Background: Gastric cancer is the second most common cause of cancer-related death in the world, and its prognosis remains poor with a median overall survival of 12 months for advanced disease. Advances in the understanding of molecular genetics have led to the development of directed molecular targeted therapy in gastric cancer, leading to improve patient outcomes and quality of life.

Discussion: In the treatment of human epidermal growth factor receptor 2 (HER2)-positive gastric cancer, the addition of trastuzumab significantly improves survival in the first-line setting of therapy. Ramucirumab, an antibody directed against vascular endothelial growth factor receptor 2, significantly improved progression-free and overall survival and has been approved for second-line treatment of gastric cancer. Anti-mesenchymal-epithelial transition (c-MET), mammalian target of rapamycin inhibitors, and polo-like kinase 1 inhibitors are under investigation as a novel therapeutic option for the treatment of gastric cancer. The novel therapies target the key immune checkpoint interaction between a T cell co-inhibitory receptor called programmed death 1 (PD-1) and one of its immunosuppressive ligands, PD-L1. This article reviews molecular targeted therapies in gastric cancer, in light of recent advances.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12029-016-9806-8DOI Listing
June 2016

Liver metastases from adenocarcinomas of unknown primary site: management and prognosis in 68 consecutive patients.

Wien Klin Wochenschr 2016 Jan 15;128(1-2):42-7. Epub 2015 Sep 15.

Department of Internal Medicine, Division of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.

Background: In this retrospective study, we aimed to evaluate the clinicopathological characteristics of the patients presenting with liver metastases from unknown primary site besides survival rates, treatment outcomes, and prognostic factors.

Methods: In all, 68 patients followed-up at our center with adenocarcinoma of unknown primary (ACUP) metastatic to the liver between 2005 and 2013 were enrolled. All of the liver metastases were proven by liver biopsy and all yielded diagnosis of adenocarcinoma.

Results: Median age was 61 years (29-90) and most of the patients were male (male/female: 43/25). The liver was the only metastatic site in 2 (3%) patients whilst 66 patients (97%) had extrahepatic metastases. The most common extrahepatic metastatic sites were lymph nodes (89.7%), lungs (32.4%), bones (25%), peritoneum (11.8%), brain (4.4%), and adrenal glands (2.9%). Of all 68 patients, 39 (57.4%) were treated with chemotherapy. Median overall survival (OS) was significantly higher in ACUP patients treated with chemotherapy [12.5 months (95% CI 8.3-16.7) vs. 4 months (95% CI 1.2-6.8), (p = 0.026), respectively]. In multivariate analysis, ECOG (Eastern Cooperative Oncology Group) performance status (p = 0.009), chemotherapy (p = 0.024), serum albumin (p = 0.012), and serum CA 19-9 level (p = 0.026) at initial diagnosis were identified as independent prognostic factors influencing survival for the patients with liver metastases from ACUP.

Conclusion: Patients with liver metastases from ACUP have poor prognosis and chemotherapy improves survival. Decreased serum albumin level, increased CA 19-9 level and poor performance status are independent poor prognostic factors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00508-015-0858-8DOI Listing
January 2016

Impact of adjuvant treatment modalities on survival outcomes in curatively resected pancreatic and periampullary adenocarcinoma.

Chin J Cancer Res 2015 Aug;27(4):408-16

1 Department of Medical Oncology, Faculty of Medicine, Cumhuriyet University, Sivas 58140, Turkey ; 2 Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara 06560, Turkey ; 3 Department of Medical Oncology, Faculty of Medicine, Dokuz EylulUniversity, Izmir 35340, Turkey ; 4 Department of Medical Oncology, Faculty of Medicine, Necmettin Erbakan University, Konya 42080, Turkey ; 5 Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul 34000, Turkey ; 6 Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara 06560, Turkey ; 7 Department of Medical Oncology, Numune Education and Research Hospital, Ankara 06100 Turkey ; 8 Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61000, Turkey ; 9 Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22020, Turkey ; 10 Department of Medical Oncology, Rize Education and Research Hospital, Rize 53200, Turkey ; 11 Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir 21280, Turkey ; 12 Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul 34668, Turkey ; 13 Department of Medical Oncology, Sakarya Education and Research Hospital, Sakarya 54050, Turkey ; 14 Department of MedicalOncology, Faculty of Medicine, Pamukkale University, Denizli 20070, Turkey ; 15 Department of Medical Oncology, Faculty of Medicine, Inonu University, Malatya 44315, Turkey ; 16 Department of Medical Oncology, Faculty of Medicine, Firat University, Elazig 23200, Turkey ; 17 Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Education and Research Hospital, Ankara 06200, Turkey ; 18 Department of Medical Oncology, Faculty of Medicine, Yuzuncu Yil University, Van 65080, Turkey ; 19 Department of Medical Oncology, Faculty of Medicine, Erciyes University, Kayseri 38000, Turkey ; 20 Department of Medical Oncology, Faculty of Medicine, SutcuImam Univer

Background: We examined the impact of adjuvant modalities on resected pancreatic and periampullary adenocarcinoma (PAC).

Methods: A total of 563 patients who were curatively resected for PAC were retrospectively analyzed between 2003 and 2013.

Results: Of 563 patients, 472 received adjuvant chemotherapy (CT) alone, chemoradiotherapy (CRT) alone, and chemoradiotherapy plus chemotherapy (CRT-CT) were analyzed. Of the 472 patients, 231 were given CRT-CT, 26 were given CRT, and 215 were given CT. The median recurrence-free survival (RFS) and overall survival (OS) were 12 and 19 months, respectively. When CT and CRT-CT groups were compared, there was no significant difference with respect to both RFS and OS, and also there was no difference in RFS and OS among CRT-CT, CT and CRT groups. To further investigate the impact of radiation on subgroups, patients were stratified according to lymph node status and resection margins. In node-positive patients, both RFS and OS were significantly longer in CRT-CT than CT. In contrast, there was no significant difference between groups when patients with node-negative disease or patients with or without positive surgical margins were considered.

Conclusions: Addition of radiation to CT has a survival benefit in patients with node-positive disease following pancreatic resection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3978/j.issn.1000-9604.2015.08.03DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560744PMC
August 2015

The impact of immunohistochemical staining with ezrin-carbonic anhydrase IX and neuropilin-2 on prognosis in patients with metastatic renal cell cancer receiving tyrosine kinase inhibitors.

Tumour Biol 2015 Nov 31;36(11):8471-8. Epub 2015 May 31.

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

The identification of prognostic factors in patients with renal cell carcinoma (RCC) represents an area of increasing interest. In this retrospective study, we evaluated the prognostic role of carbonic anhydrase-IX, ezrin, and neuropilin in metastatic RCC patients. The expression of several biomarkers were measured by immunohistochemistry (IHC) in 45 patients with advanced stage RCC treated with second-line tyrosine kinase inhibitors (TKIs) targeting vascular endothelial growth factor (VEGF) after failure of interferon-alpha between January 2007 and June 2012. Kaplan-Meier curves and log-rank tests were used for analysis of progression-free survival (PFS) and overall survival (OS), and a multivariate Cox proportional hazard model was employed to identify factors with an independent effect on the survival. Age, ezrin and neuropilin-2 overexpression were found to be statistically significant factors (P < 0.05) for PFS in the univariate analysis. Ezrin and neuropilin-2 overexpression, hemoglobin and albumin level were statistically significant factors (P < 0.05) for OS in the univariate analysis. Multivariate analysis revealed that low expression of ezrin and neuropilin-2 was an independent prognostic factor for PFS and OS. The median PFS was 4 months for patients overexpressing neuropilin-2 versus 11 months for those with lower expression of neuropilin-2 (p = 0.033). The median OS was longer in patients with low levels of neuropilin-2 expression (26 months) compared to patients overexpressing neuropilin-2 (13 months) (p = 0.023). Increased expression of ezrin was associated with poor prognosis in patients treated with TKIs targeting VEGF (PFS, 3 vs 7 months; p = 0.012). High ezrin expression was associated with shorter OS (p = 0.009). This is the first study in the literature showing that neuropilin-2 and ezrin are related with prognosis in patients with advanced RCC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13277-015-3589-6DOI Listing
November 2015

Factors predicting the development of distant metastases in patients with head and neck squamous cell carcinoma: A retrospective study from a single centre.

J BUON 2015 Mar-Apr;20(2):521-6

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

Purpose: The presence of distant metastases (DMs) after the initial treatment of head and neck squamous cell carcinoma is associated with a poor outcome. The incidence of DMs in head and neck cancer is about 4-26%. The purpose of this study was to evaluate the prevalence of distant metastases and the factors predicting the development of DMs.

Methods: Between January 2000 and December 2010, 292 patients with head and neck squamous cell carcinoma were included in this study.

Results: Thirty three patients (11.3%) developed local recurrences, 27 patients (9.2%) developed DMs. The median post DMs survival was 23.4 months (range 1.8-229.1). The factors that significantly increased the risk of DMs were the presence of local recurrence (p=0.0001, OR:17.32, 95% CI:4.86-19.90), pathologically positive neck (p=0.008, OR:5.97, 95% CI: 3.25-10.45), and primary tumor localized in oral cavity or lip (p=0.035, OR:2.6, 95% CI:1.43-4.65).

Conclusion: Patients with these factors should be considered candidates for adjuvant systemic treatment and evaluated for early detection of DMs during follow-up.
View Article and Find Full Text PDF

Download full-text PDF

Source
July 2015

Factors Influencing Chemotherapy Goal Perception in Newly Diagnosed Cancer Patients.

J Cancer Educ 2016 Jun;31(2):308-13

Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology, Gazi University, Ankara, Turkey.

Cancer patients who start receiving chemotherapy have difficulty in understanding the state of their disease, the prognosis, and the purpose of treatment. We used a survey to evaluate the extent of perception of chemotherapy goal among cancer patients. Two hundred sixteen cancer patients who received chemotherapy for the first time participated in the study. The presence of depression and anxiety was assessed using the "Hospital Anxiety and Depression Scale" (HAD). The consistency between the patients' perception of the chemotherapy goal and the physician's perception was described as "right," and the inconsistency was described as "wrong." Among the patients who participated in the survey, 53.2 % (n = 115) were receiving adjuvant treatment and 46.8 % (n = 101) were receiving palliative treatment for metastatic disease. The rate of right and wrong perception of the chemotherapy goal was 51.9 % (n = 108) and 32.2 % (n = 67), respectively, and the rate of confused patients was 18.9 % (n = 41). The level of education was shown to be the only parameter involved in accurate perception of the treatment purpose (hazard ratio (HR) = 0.444, p = 0.025, 95 % confidence interval (CI) 0.219-0.903). In this study, there was a 51.9 % consistency between the physician's perception and that of the patient regarding the purpose of treatment. We demonstrated that the level of education was the unique factor in accurate perception of chemotherapy goal among cancer patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s13187-015-0827-yDOI Listing
June 2016

Sonographic assessment of fatty liver: intraobserver and interobserver variability.

Int J Clin Exp Med 2014 15;7(12):5453-60. Epub 2014 Dec 15.

Department of Radiology, Dicle University Faculty of Medicine Diyarbakır, Turkey.

Non-alcoholic fatty liver disease (NAFLD) is a common liver disease worldwide and ultrasonography is widely used in the diagnosis and the follow-up we purposed to assess intraobserver and interobserver variability in the sonographic evaluation of the existence and steatosis grades of NAFLD. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and AST to ALT (AST/ALT) ratio were compared between the grades of hepatosteatosis. Hepatic ultrasonography (US) examinations consisted of 5-10 static images of 113 successive adult patients, whose records were in the picture archiving and communication system (PACS) of our hospital were retrospectively evaluated by two experienced radiologists. Hepatic images were graded into 4 groups; as normal, mild, moderate or severe hepatic steatosis. Evaluation of hepatic steatosis of the same set of images was repeated after one month under the same conditions. Interobserver and intraobserver agreement was assessed by using kappa (κ) statistics. In each group, the percentage of individuals with high ALT and/or AST, or AST/ALT ratio over 1 was calculated. The intraobserver agreement was 51%, fair kappa (κ=0.356) for observer 1; and 68%, moderate (κ=0.591) for observer 2. The interobserver agreements in the initial and second readings were 39% and 40%, fair (κ=0.208) and (κ=0.225), respectively. Elevations of ALT and/or AST levels were similar between groups depending on the degree of hepatosteatosis among the patients. Visual assessment of NAFLD by ultrasonography has substantial interobserver variability, and reproducibility of results is limited. More objective imaging modalities are needed to evaluate the degree of hepatosteatosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307502PMC
February 2015

Dynamic multidetector computed tomography findings of hepatocellular carcinoma of hepatitis B virus-positive and -negative patients.

Cancer Imaging 2014 Apr 22;14. Epub 2014 Apr 22.

Background: The objective of this study was to retrospectively investigate and compare multidetector computed tomography findings of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-positive and -negative patients.

Methods: Triphasic (arterial, portal venous, and delayed phases) dynamic multidetector computed tomography (CT) was performed in 83 patients with HCC, 48 of whom were HBV-positive. The diagnosis of HCC was established with typical CT imaging findings (68 patients) or histopathological evaluation (15 patients). Distribution of solitary, multiple, and diffuse HCC, portal/hepatic vein thrombosis, metastasis, and patients with high alpha-fetoprotein levels in the HBV-positive and -negative groups were compared using the Kolmogorov-Smirnov test. Lesion size, alpha-fetoprotein levels, arterial, portal, delayed enhancement, and washout of lesions were compared using the Student's t-test.

Results: Hypervascular tumors were observed in 72 (87%) patients, and hypovascular tumors were found in 11 (13%) patients. The mean alpha-fetoprotein value of HBV-positive patients with HCC was significantly higher than the mean alpha-fetoprotein value of HBV-negative patients (P < 0.05). Portal/hepatic vein thrombosis and metastasis were more frequently observed in HBV-positive patients (P < 0.05). The frequencies of solitary, multiple, and diffuse lesions in HBV-positive and -negative patients were not significantly different (P > 0.05). The mean diameters, arterial, portal, and delayed phase attenuations, and washout of HCC were not significantly different (P > 0.05).

Conclusions: Multidetector CT imaging findings of HCC in HBV-positive and -negative patients are alike. Portal/hepatic vein thrombosis and metastasis are more frequently observed in HBV-positive patients. Alpha-fetoprotein levels are higher in HBV-positive patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1470-7330-14-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331841PMC
April 2014

Mycotoxin production capability of Penicillium roqueforti in strains isolated from mould-ripened traditional Turkish civil cheese.

Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015 12;32(2):245-9. Epub 2015 Jan 12.

a Department of Food Engineering , Atatürk University , Erzurum , Turkey.

Mould-ripened civil is a traditional cheese produced mainly in eastern Turkey. The cheese is produced with a mixture of civil and whey curd cheeses (lor). This mixture is pressed into goat skins or plastic bags and is ripened for more than three months. Naturally occurring moulds grow on the surface and inside of the cheese during ripening. In this research, 140 Penicillium roqueforti strains were isolated from 41 samples of mould-ripened civil cheese collected from Erzurum and around towns in eastern Turkey. All strains were capable of mycotoxin production and were analysed using an HPLC method. It was established that all the strains (albeit at very low levels) produced roquefortine C, penicillic acid, mycophenolic acid and patulin. The amounts of toxins were in the ranges 0.4-47.0, 0.2-43.6, 0.1-23.1 and 0.1-2.3 mg kg(-1), respectively. Patulin levels of the samples were lower than the others. The lowest level and highest total mycotoxin levels were determined as 1.2 and 70.1 mg kg(-1) respectively. The results of this preliminary study may help in the choice of secondary cultures for mould-ripened civil cheese and other mould-ripened cheeses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/19440049.2014.997808DOI Listing
December 2015

Factors predicting recurrence in patients with grade III glial tumors: impact of adjuvant temozolomide on recurrence.

J BUON 2014 Oct-Dec;19(4):1035-40

Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.

Purpose: The purpose of this study was to evaluate the clinicopathological features of patients with grade III glial tumors associated with recurrence after treatment.

Methods: A retrospective analysis was carried out on 67 patients with grade III glial tumors between May 2007 and June 2013. Data were retrieved from patient electronic medical records and paper charts.

Results: The patient median age was 43 years (range 19-707 rpar;. Of these, 50.7% (N=34) had anaplastic astrocytoma, 29.9% (N=20) anaplastic oligoastrocytoma and 19.4% (N=13) anaplastic oligodendroglioma. Among these 67 patients, 41 (61.2%) developed local recurrence. Fifty seven of them (80.6%) received radiotherapy (RT) with concomitant temozolomide. Of these patients, 14 (20.9%) received RT with concomitant temozolomide alone, and 43 (64.2%) were treated with concomitant chemoradiotherapy followed by adjuvant temozolomide. Time to recurrence (TTR) of patients who received adjuvant temozolomide after concomitant chemoradiation (TTR=14 months, 95% CI 9.3-22.77 rpar; as initial treatment for grade III glial tumors was not superior to RT with concomitant temozolomide alone (TTR=21 months, 95% CI 14.8-35.2; p=0.224) In multivariate analysis, histologic subtype (p=0.015), age (p=0.019) and presence of neurologic symptoms (p=0.021) were independent predictive factors of recurrence.

Conclusion: This analysis demonstrated that histologic subtype, age and presence of neurologic symptoms were significantly associated with recurrence in patients with grade III glial tumors. Adjuvant temozolomide was not significantly associated with recurrence in patients with grade III glial tumors. The identification of these predictors may be important for the patient follow-up and better treatment modifications.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2018

Association between survival and maximum standardized uptake value of liver metastases detected by 18-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography in patients with adenocarcinoma of unknown primary origin.

Ann Nucl Med 2014 Nov 1;28(9):891-6. Epub 2014 Oct 1.

Department of Medical Oncology, Ankara Numune Education and Research Hospital, Sihhiye, 06100, Ankara, Turkey,

Objective: The objective of this retrospective study is to investigate the association between survival and maximum standardized uptake values (SUVmax) of liver metastases detected by pre-treatment positron emission tomography-computed tomography (PET-CT) in patients with adenocarcinoma of unknown primary origin (ACUP).

Methods: A total of 58 patients with ACUP and liver metastases confirmed histopathologically by liver biopsy and pre-treatment PET-CT were included in this study. SUVmax values of the liver lesions were measured and their association with survival was investigated.

Results: The median age was 62 years; 63.8 % of the patients were males and 36.2 % were females. The median overall survival was calculated as 10.7 months (OS). The median SUVmax of the liver metastases was 8.6. Accordingly, two groups were established: one with values <8.6 and the other with ones ≥8.6. No differences were detected between the two groups with respect to general characteristics. Median OS was 13.2 months in the group with SUVmax <8.6 compared to 7.4 months in the group with SUVmax ≥8.6. This difference was statistically significant (p = 0.033). SUVmax (HR 1.104, 95 % CI 1.013-1.204, p = 0.025), age (HR 1.033, 95 % CI 1.002-1.064, p = 0.034), presence of chemotherapy (HR 2.296, 95 % CI 1.136-4.641, p = 0.021) and LDH level (HR 1.002, 95 % CI 1.001-1.003, p = 0.007) were identified as independent prognostic factors affecting survival in the multivariable analysis. This is the first report evaluating the impact of SUVmax for liver metastases on ACUP patient survival.

Conclusion: The SUVmax of liver metastases evaluated by PET-CT is a prognostic factor influencing survival of patients with ACUP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12149-014-0896-8DOI Listing
November 2014

Adjuvant systemic chemotherapy with or without bevacizumab in patients with resected pulmonary metastases from colorectal cancer.

Thorac Cancer 2014 Sep 25;5(5):398-404. Epub 2014 Aug 25.

Department of Medical Oncology, Gazi University Faculty of Medicine Ankara, Turkey.

Introduction: We investigated the impact of modern chemotherapy regimens and bevacizumab following pulmonary metastasectomy (PM) from metastatic colorectal cancer (CRC).

Methods: A total of 122 consecutive patients who were curatively resected for pulmonary metastases of CRC in twelve oncology centers were retrospectively analysed between January 2000 and April 2012.

Results: Of 122 patients, 14 did not receive any treatment following PM. The remaining 108 patients received fluoropyrimidine-based (n = 12), irinotecan-based (n = 56) and oxaliplatin-based (n = 40) chemotherapy combinations. Among these, 52 patients received bevacizumab (BEV) while 56 did not (NoBEV). Median recurrence-free survival (RFS) was 17 months and median overall survival (OS) has not been reached at a median follow-up of 25 months after PM. Three and five-year OS rates were 66% and 53%, respectively. RFS and OS were similar, irrespective of the chemotherapy regimen or BEV use. Positive pulmonary margin, KRAS mutation status, and previous liver metastasectomy were negative independent prognostic factors for RFS, while pathologically confirmed thoracic lymph node involvement was the only negative independent prognostic for OS in multivariate analysis.

Conclusions: No significant RFS or OS difference was observed in respect to chemotherapy regimens with or without BEV in patients with pulmonary metastases of CRC following curative resection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/1759-7714.12107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4704370PMC
September 2014